椎旁神经阻滞对胸部微创术后患者疼痛缓解及快速康复效果的meta分析OA

Objective To study the effect of paravertebral nerve block on postoperative pain relief and rapid recovery in patients undergoing minimally invasive thoracic surgery.Methods Computerized search of Web of science,Clinical trail,PubMed,Embase,The Cochrane library,CNKI,Wanfang database,and VIP database,etc.,to extract the data of the studies that met the inclusion criteria,and divided them into the paravertebral group and the control group,and observe the indexes:postoperative visual analogue scale(VAS)pain score,postoperative analgesic drug use,analgesic-related adverse reactions,postoperative-related complications,and hospitalization days.Results A total of 13 articles and 1014 patients were included.In the experimental group,the postoperative pain scores were significantly reduced at 4 h(MD=-0.88,95%CI:-1.14--0.61,P<0.01),12 h(MD=-1.11,95%CI:-1.53--0.69,P<0.01),and 24 h(MD=-0.67,95%CI:-1.14--0.21,P<0.01).The incidence of analgesia-related adverse reaction rate was significantly reduced(RR=0.51,95%CI:0.36-0.72,P<0.01),the incidence of postoperative complications was significantly reduced(RR=0.53,95%CI:0.32-0.87,P<0.05),and the number of hospitalization days was significantly reduced(MD=-2.12,95%CI:-2.32--1.92,P<0.01).Conclusion Paravertebral nerve block is a relatively effective and safe form of analgesia after minimally invasive thoracic surgery,meeting the need for rapid postoperative recovery.